The Unacceptability of ‘Quality of Life’

The writer’s attention has recently been drawn to an address made by Cardinal Galen, Bishop of Munster between 1933 and 1946, on the topic of euthanasia. He was a trenchant critic of many Nazi policies, not least those towards the disabled whom the regime classified as ‘unproductive members of society’. Those resident in care homes were assessed as to their capabilities for productivity. Those deemed unproductive were removed and killed. There was at no point any effort made to consult the individuals concerned or their families.

Cardinal Galen declared:

If the principle that man is entitled to kill his unproductive fellow-man is established and applied, then woe betide all of us when we become aged and infirm! If it is legitimate to kill unproductive members of the community, woe betide the disabled who have sacrificed their health or their limbs in the productive process! If unproductive men and women can be disposed of by violent means, woe betide our brave soldiers who return home with major disabilities as cripples, as invalids!

Naturally Cardinal Galen was not much appreciated by the Nazi authorities. He was fortunate that the heavily Catholic nature of Westphalia led them to deem it probably damaging to local morale to have him ‘removed’. His address seems to us worthy of reconsideration in view of recent intensification of debate about euthanasia in the UK following news that Lord Falconer was to review the matter (again).

Fortunately, for the present at least, the vast majority of those who now arguing for euthanasia would not consider for one moment imposing any form of involuntary euthanasia. Their expressed concern is with the right of individuals to determine when they should die. As indicated last week, however, we do find fault with the idea that one should have the ‘right’ to end one’s own life.

Cardinal Galen long ago addressed the issue of ‘quality of life’ that is so often brought up in discussions on euthanasia. The notion is one necessarily subjective. One individual might view his or her life as lacking in quality if no longer able naturally to communicate with others. Another might deem life poor in quality if mobility were lost. There is no universally acceptable definition of what the possession of ‘quality’ entails, nor, therefore, can be generally agreed at what point a life ceases to have it. It is easy to envisage the point at which some majority agreed on the absence of ‘quality’ becoming that at which involuntary euthanasia might begin to occur, at least in the absence of an expressed wish to the contrary.

If euthanasia were legalised legal safe-guards would surely have to be put in place. A phrase as subjective as ‘quality of life’, were it included in legislation, might leave the law open to all-manner of judicial review and reframing. But, in any event, the apparently appropriate safeguards could not be guaranteed efficacy. An individual suffering from prolonged depression might argue that it was discriminatory to deem him non compos mentis. He might well feel that his mental state afforded him little ‘quality of life’. As such matters are now discussed almost always in the language of ‘rights’. It is therefore perfectly possible to conceive of the judiciary, in London or Strasbourg, considering it such a person’s human right to have the same access to euthanasia as other sufferers. In fact, not only would such legislation be lacking in moral quality, but also in legal quality. Good legislation cannot be redefined according to the sympathies of particular individuals or groups of individuals.

‘Quality of life’, indeed, is as subjective and objectionable a term as ‘unproductive members of society’. The use of such language leads to variable outcomes according to the beliefs and moral codes of those affected. Human life is of such importance that it is unacceptable to discuss its ending by means of subjective and ill-defined terminology.